What the San Francisco Bay Area Can Teach Us About Fighting a Pandemic

The eradication of smallpox offers lessons and insight for health officials and governments focused on containing the novel coronavirus and avoiding future pandemics. Although COVID-19 presents unique challenges – such as asymptomatic transmission – lessons from the smallpox era show that "a well-funded, well-supported public health system" was a key to success.

As Covid-19 spread throughout regions of South Africa, public health clinics began reporting seeing fewer patients for HIV viral load testing due to shelter-in-place orders. In trying to mitigate the longterm implications of people missing their appointments, a few HIV specialists have joined the frontlines in local communities to act as both coronavirus testers and information conduits for HIV programs.

Rwanda, a country with the same population of Ohio, has emerged as an example of how to slow the spread of coronavirus, with only 1,500 cases reported so far. Besides initiating a lockdown, implementing free testing, and recruiting community health care workers, police, and college students to be contact tracers, officials also used "the same structure, same people, same infrastructure and laboratory diagnostics" that had been working to contain the spread of HIV.

Two community living facilities have played integral roles in combatting the spread of diseases throughout New York's history by relying on mutual aid models. In the 1980's the Manhattan Plaza residence started the AIDS Project, which "assigned care partners to every person who got sick and deployed volunteers to deliver meals and get people to doctors." Now, as the COVID-19 pandemic poses a threat, similar efforts are underway by a younger generation at the Manhattan Plaza as well as at Penn South where the focus has been on keeping senior citizens safe.

West Virginia relied on strategic partnerships, collaboration, and efficient use of medicine to successfully outpace every other state in the U.S. in COVID-19 vaccine distribution. Rather than turning to nationally-run chain pharmacies to disseminate the vaccine, the state partnered with local pharmacies to better reach long-term care facilities and collaborated with the West Virginia National Guard to overcome logistical barriers.

When a smallpox outbreak was deemed to be a likelihood in New York City in 1947, the city’s health commissioner rapidly launched a vaccination campaign that leveraged internal collaboration, consistent and transparent communication, and contact tracing. The effort culminated in more than six million people receiving vaccination in under a month, and only 12 infections and two deaths total. While this "public health triumph" hold lessons for the current COVID-19 pandemic, experts caution, “It’s almost inconceivable that we’re going to be able to do something similar as rapidly and as effectively.”

The Bridges to Health program in Oregon is helping to improve community health by connecting individuals and families to resources such as housing, food aid, transportation options, and health-care facilities. Although the COVID-19 pandemic has changed how the program works and not all clients are receptive to aid, "the program’s cross-sector model, its ability to quickly shift gears, and its resilient staff have allowed it to address the community’s changing needs."

When nursing homes in North Carolina realized that the coronavirus pandemic had arrived within the state, facility managers and staff began enacting measures to prevent the spread of the virus amongst their residents. Adapting existing infection control and prevention plans, many were able to ensure a robust supply of PPE and reinforce their staffing numbers, which has paid off as most of the facilities have avoided outbreaks.

A group of health care workers and social workers formed to help connect hard-to-reach communities in Hawaii to COVID-19 testing and information about the pandemic. So far, they have been able to test more than 200 people who were showing symptoms or who had been at high risk of exposure. The director of the Hawaii Public Housing Authority has also reported that compliance with mask-wearing and other safety measures has increased since the effort began.

Two newly-formed companies in Ohio are the nation's first businesses to create a "fully automated production of woven, washable masks." The project became a reality thanks to partnerships and funding support between state agencies, the Ohio Hospital Association, and a nonprofit consulting group. While the masks aren't medical grade, they are "washable, snug, and easy to take on and off without touching the contaminated part."